The objective of the proposed research is to develop and demonstrate Random Hand Hygiene Prompts (RHHP). RHHP will deliver voice messages at random times on a hospital floor, reminding listeners to perform hand hygiene. Preliminary results suggest that listeners, who include nurses, physicians, visitors and patients themselves, respond to these messages by voluntarily increasing their hand hygiene. As a result, nosocomial infections will decrease, saving lives and money. The Phase I research will demonstrate RHHP in a hospital. RHHP hardware includes sensors to detect soap and gel use and a computer, which both collects and stores data from the sensors and generates voice messages over speakers on the hospital floor. The research will include a baseline phase, during which hand hygiene is recorded but no voice messages are played; and an intervention phase, during which hand hygiene is recorded as before and voice messages are played. "Hand hygiene compliance" is defined here as the number of soap and alcohol gel uses per patient day. We will claim that RHHP is feasible if hand hygiene compliance increases significantly, at the 5% level, from the baseline to the intervention phase. In Phase II we plan to install RHHP at one or more hospitals and test it for an extended time, to demonstrate a reduction in nosocomial infections. In Phase III we plant to commercialize RHHP in conjunction with our partner, Steris Corporation. This research will demonstrate that hospital workers and others can be encouraged to wash and sanitize their hands by means of automated voice messages. As a result of the work proposed here, hospital acquired infections, those acquired after admission, will be reduced because the link between one patient's infection and another's, via health care worker's hands, will be broken. Then the approximately 90,000 U.S. deaths per year, and other costs due to hospital acquired infections, will decrease as well. Random Hand Hygiene Prompts will encourage hand washing and hand sterilization in hospitals. It will affect public health by reducing the chance of a patient acquiring an infection in a hospital - a public place. RHHP has the potential to reduce the cost of hospital acquired infections by a billion dollars and a hundred thousand deaths per year in the United States. [unreadable] [unreadable] [unreadable] [unreadable]